Short Answer

In North Carolina, you usually find out whether your health plan can be paid back (often called “reimbursement” or “subrogation”) by identifying what kind of plan it is and then requesting the plan’s written subrogation/reimbursement terms and a lien or repayment statement for your accident-related bills. Some plans (like Medicaid or the State Health Plan) have specific rights set by statute, while many employer plans follow federal ERISA rules and rely heavily on the plan document language. If your case is already settled, you still need to confirm the plan’s claim before settlement funds are fully disbursed.

Understanding the Problem

If you were hurt in a North Carolina car wreck and your health insurance paid for treatment, you may be asking: “Can my health plan demand repayment from my settlement now that the at-fault claim is resolved?” In your situation, one key fact is that the liability claim has already been settled, which makes it important to quickly confirm whether a reimbursement claim exists and, if it does, how much the plan says it is owed.

Apply the Law

North Carolina uses a mix of (1) contract rules (what your health plan documents say) and (2) specific statutes for certain payors (like Medicaid and the State Health Plan). The first step is to identify the type of coverage that paid the bills (employer plan, individual plan, Medicaid, Medicare, State Health Plan, etc.). Then you confirm whether that payor asserts a reimbursement/subrogation right and whether it has issued a lien or claim tied to your accident-related medical charges. For statutory programs, the forum and timing can matter—especially for Medicaid disputes, which can require a court filing within a short window after settlement.

Key Requirements

• Identify the payor and plan type: The rules change depending on whether the bills were paid by Medicaid, the State Health Plan, an employer-sponsored plan, or another insurer.
• Get the plan’s written reimbursement language: For many private plans, the right to be paid back depends on the plan document (often called the plan booklet, certificate of coverage, or summary plan description).
• Confirm the plan is claiming accident-related payments: A valid claim usually ties to medical payments the plan says were caused by the crash (not unrelated care).
• Request a payoff/lien statement: You need a written itemization of what the plan claims it paid and what it demands back before funds are distributed.
• Watch for statutory notice and dispute deadlines: Some programs (notably Medicaid) have specific timelines that can start running when the settlement is executed or proceeds are received.
• Coordinate disbursement through your attorney’s trust account: When a lien or reimbursement claim exists, settlement funds are typically held and resolved before final distribution to the client.

What the Statutes Say

• N.C. Gen. Stat. § 108A-57 (Medicaid subrogation; presumptions; court dispute process) - Gives North Carolina Medicaid subrogation rights and sets presumptions and a process (with deadlines) to dispute the Medicaid portion of a recovery.
• N.C. Gen. Stat. § 135-48.37 (State Health Plan subrogation and lien) - Provides subrogation and lien rights for the State Health Plan and includes limits and priority rules.
• N.C. Gen. Stat. § 44-49 (Medical provider liens on personal injury recoveries) - Creates a lien framework for certain medical providers and entities and includes notice and documentation requirements.

Analysis

Apply the Rule to the Facts: Because your motor-vehicle collision claim has already been settled and health insurance likely paid for treatment related to back pain and headaches, the practical question is whether the payor is asserting a reimbursement/subrogation claim tied to those accident-related charges. Your law firm opening a file with a recovery vendor is a common step to identify the plan type, obtain the controlling plan language (or statutory basis), and request an itemized payoff so the settlement can be disbursed correctly. The key is confirming the claim in writing and matching it to the accident-related payments before any final distribution.

Process & Timing

1. Who files: Usually no “filing” is required just to find out; the injured person (through counsel) requests information from the health plan or its recovery vendor. Where: With the health plan’s subrogation/recovery department (or its vendor). What: A written request for (a) the plan’s subrogation/reimbursement provisions and (b) an itemized lien/payoff statement for accident-related claims. When: As soon as you know a settlement is coming—or immediately after settlement if it has already resolved.
2. Confirm the plan category and rules: If it is Medicaid, North Carolina law provides presumptions about how much of the gross recovery is attributed to the Medicaid claim and allows a court process to dispute that amount; the dispute timing can be triggered by execution/approval of the settlement or entry of judgment.
3. Resolve and document the payoff before disbursement: Once the plan confirms the amount (or the parties reach an agreement, or a court determines the amount for Medicaid disputes), the lien/reimbursement claim is paid from the settlement proceeds and the file is documented with a final payoff letter or satisfaction confirmation.

Exceptions & Pitfalls

• Not all “health insurance” is treated the same: Medicaid and the State Health Plan have statutory rights; many employer plans rely on plan language and federal rules, so you cannot assume the same outcome across plans.
• Confusing provider liens with health plan reimbursement: A hospital/doctor lien under North Carolina law is different from a health plan’s subrogation claim. You may have one, both, or neither.
• Missing the Medicaid dispute window: If Medicaid is involved and you want to challenge the presumed amount, waiting too long can take options off the table.
• Paying the wrong amount because the ledger is not itemized: Always request an itemized statement that ties charges to dates of service and confirms they are accident-related.
• Assuming the claim disappears after settlement: A plan may still pursue repayment after the liability case settles, so it is safer to confirm and resolve the claim before final distribution.

Conclusion

In North Carolina, the way to find out whether your health plan has a right to be paid back from your car accident settlement is to identify the type of plan that paid the bills and then obtain (in writing) the plan’s reimbursement/subrogation terms and an itemized payoff statement for accident-related payments. If Medicaid is involved, there can be a 30-day deadline to ask a court to determine the Medicaid portion after the settlement is executed. Next step: request the plan documents and a written lien/payoff statement from the plan or its recovery vendor.

Talk to a Personal Injury Attorney

If you’re dealing with a health plan reimbursement claim after a North Carolina car accident settlement, our firm has experienced attorneys who can help you identify the type of plan involved, confirm whether a valid claim exists, and understand the timelines for resolving it before funds are disbursed. Reach out today.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.